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Kumar V, Vatkar AJ, Kataria M, Dhatt SS, Baburaj V. Virtual reality is effective in the management of chronic low back ache in adults: a systematic review and meta-analysis of randomized controlled trials. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:474-480. [PMID: 37979068 DOI: 10.1007/s00586-023-08040-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 10/23/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Chronic low back ache (CLBA) is a common condition that is conventionally managed with physical therapy and analgesics. Recently, virtual reality-based interventions have been tried out in the management of CLBA. Their effectiveness, however has not been established. This meta-analysis aims to find out if the application of VR will lead to better pain relief, as compared to conventional techniques in adults with CLBA. METHODS The literature search was carried out in three online databases for potential randomized controlled trials that compared VR-based interventions with conventional treatment in CLBA. Data on outcome parameters were recorded. Meta-analysis was carried out with the help of appropriate software. RESULTS Seven studies having data on 507 subjects were included in the meta-analysis. Their mean ages were 48.4 years. There were 252 subjects in the VR group and 255 in the control group. VR-based interventions were found to have a statistically significant improvement in the pain intensity compared with conventional techniques (p - 0.005). CONCLUSION VR-based interventions are effective in the management of CLBA in the short term. Further research with longer follow-up is required to evaluate if these improvements are persistent in the long term.
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Affiliation(s)
- Vishal Kumar
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Mohak Kataria
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sarvdeep Singh Dhatt
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vishnu Baburaj
- Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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Ionescu D, Iacob CI, Brehar FM, Avram E. The role of catastrophizing and basic psychological needs satisfaction on health-related quality of life and pain in patients with lumbar disc herniation. Front Psychol 2023; 14:1147254. [PMID: 37425150 PMCID: PMC10323192 DOI: 10.3389/fpsyg.2023.1147254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Lumbar disc herniation (LDH) is one of the most common conditions associated with functional disability, affecting patients' quality of life (QOL). Disability can be affected by cognitive factors, such as pain catastrophizing. Similarly, unfulfilled basic psychological needs (i.e., autonomy, competence, relatedness) are associated with biases in pain perception and QOL. Using the fear-avoidance model and the self-determination theory, this study investigates: (1) the separate contribution of pain-related variables and basic psychological needs satisfaction in predicting QOL in patients proposed for LDH surgery; (2) pre- and post-surgical differences in pain catastrophizing and basic psychological needs satisfaction. Methods First, we used hierarchical regression on 193 patients (Mage = 46.10, SDage = 11.40) to identify predictors of QOL. Second, we performed paired t-tests on 55 patients to investigate pre- and post-surgical differences in pain catastrophizing and basic psychological needs satisfaction. Results Hierarchical regression showed that the model predicts 27% of the variance in QOL; medium pain level, age, pain catastrophizing, and basic psychological needs satisfaction were significant predictors. Also, pain catastrophizing significantly decreased after surgery [t (54) = 6.07, p < 0.001, Cohen's d = 0.81], but basic psychological needs satisfaction did not modify significantly. Discussion This research confirms the importance of pain perception and pain catastrophizing for LDH patients' QOL and broadens the applicability of the self-determination theory for spinal patients.
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Affiliation(s)
- Daniela Ionescu
- Department of Sociology, National School of Political and Administrative Studies, Bucharest, Romania
| | - Claudia Iuliana Iacob
- Laboratory of Health Psychology and Clinical Neuropsychology, Department of Applied Psychology and Psychotherapy, Faculty of Psychology and Educational Sciences, University of Bucharest, Bucharest, Romania
| | - Felix Mircea Brehar
- Department of Neurosurgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Eugen Avram
- Laboratory of Health Psychology and Clinical Neuropsychology, Department of Applied Psychology and Psychotherapy, Faculty of Psychology and Educational Sciences, University of Bucharest, Bucharest, Romania
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Shepherd MH, Shumway J, Salvatori RT, Rhon DI, Young JL. The influence of manual therapy dosing on outcomes in patients with hip osteoarthritis: a systematic review. J Man Manip Ther 2022; 30:315-327. [PMID: 35192442 PMCID: PMC9621225 DOI: 10.1080/10669817.2022.2037193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To 1) Determine if specific dosing parameters of manual therapy are related to improved pain, disability, and quality of life outcomes in patients with hip osteoarthritis and 2) to provide recommendations for optimal manual therapy dosing based on our findings. DESIGN A systematic review of randomized controlled trials from the PubMed, CINAHL, and OVID databases that used manual therapy interventions to treat hip osteoarthritis was performed. Three reviewers assessed the risk of bias for included studies and extracted relevant outcome data based on predetermined criteria. Baseline and follow-up means and standard deviations for outcome measures were used to calculate effect sizes for within and between-group differences. RESULTS Ten studies were included in the final analyses totaling 768 participants, and half were graded as high risk of bias. Trends emerged: 1) large effect sizes were seen using long-axis distraction, mobilization and thrust manipulation, 2) mobilization with movement showed large effects for pain and range of motion, and (3) small effects were associated with graded mobilization. Durations of 10 to 30 minutes per session, and frequency 2-3 times per week for 2-6 weeks were the most common dosing parameters. CONCLUSIONS There were varied effect sizes associated with pain, function, and quality of life for both thrust and non-thrust mobilizations, and mobilization with movement into hip flexion and internal rotation. Due to the heterogeneity of MT dosage, it is difficult to recommend a specific manual therapy dosage for those with hip osteoarthritis.
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Affiliation(s)
- Mark H. Shepherd
- Department of Physical Therapy Bellin College, Doctor of Science in Physical Therapy Program, Green Bay, WI, USA,CONTACT Mark H. Shepherd Bellin College, Doctor of Science in Physical Therapy Program, 3201 Eaton Rd, Green Bay, WI54311, USA
| | - Joshua Shumway
- Department of Physical Therapy Bellin College, Doctor of Science in Physical Therapy Program, Green Bay, WI, USA
| | - Robert T. Salvatori
- Department of Physical Therapy Bellin College, Doctor of Science in Physical Therapy Program, Green Bay, WI, USA
| | - Daniel I. Rhon
- Department of Physical Therapy Bellin College, Doctor of Science in Physical Therapy Program, Green Bay, WI, USA
| | - Jodi L. Young
- Department of Physical Therapy Bellin College, Doctor of Science in Physical Therapy Program, Green Bay, WI, USA
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Bélanger C, Dumoulin C, Bergeron S, Mayrand MH, Khalifée S, Waddell G, Dubois MF, Morin M. Pain Characteristics, Fear-avoidance Variables, and Pelvic Floor Function as Predictors of Treatment Response to Physical Therapy in Women With Provoked Vestibulodynia. Clin J Pain 2022; 38:360-367. [PMID: 35258030 DOI: 10.1097/ajp.0000000000001030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 02/02/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim was to investigate whether pretreatment pain characteristics, psychological variables, and pelvic floor muscle (PFM) function predict the response to physical therapy (PT) in women with provoked vestibulodynia (PVD). MATERIALS AND METHODS One hundred-five women diagnosed with PVD underwent 10 weekly sessions of individual PT comprising education, PFM exercises with biofeedback, manual therapy, and dilators. Treatment outcomes were evaluated at pretreatment, post-treatment, and 6-month follow-up and included pain intensity (numerical rating scale 0 to 10) and sexual function (Female Sexual Function Scale). Multilevel analyses were used to examine the potential predictors of response over time including pain characteristics (PVD subtype, pain duration), psychological variables (fear of pain, pain catastrophizing), and PFM function assessed with a dynamometric speculum (tone, flexibility, and strength). RESULTS PVD subtype and PFM tone were significant predictors of greater treatment response for pain intensity reduction. Secondary PVD (ie, pain developed after a period of pain-free intercourse) and lower PFM tone at baseline were both associated with greater reduction in pain intensity after PT and at follow-up. Among the psychological variables, fear of pain was the only significant predictor of better treatment response when assessed through improvement in sexual function, where higher fear of pain at baseline was associated with greater improvement after PT. DISCUSSION This study identified PVD secondary subtype, lower PFM tone, and higher fear of pain as significant predictors of better treatment response to PT in women with PVD.
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Affiliation(s)
- Clémence Bélanger
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke and Research Center of the Centre Hospitalier Universitaire de Sherbrooke (CHUS)
| | - Chantale Dumoulin
- School of Rehabilitation, Faculty of Medicine, Université de Montréal and Research Center of the Institut Universitaire de gériatrie de Montréal
| | | | - Marie-Hélène Mayrand
- Departments of Obstetrics and Gynecology and Social and Preventive Medicine, Université de Montréal and Research Center of the Centre hospitalier de l'Université de Montréal
| | - Samir Khalifée
- Jewish General Hospital and Royal Victoria Hospital, McGill University Health Center, Montréal, QC, Canada
| | - Guy Waddell
- Department of Obstetrics and Gynecology, CHUS and Université de Sherbrooke
| | | | - Mélanie Morin
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke and Research Center of the Centre Hospitalier Universitaire de Sherbrooke (CHUS)
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Developing Clinical and Research Priorities for Pain and Psychological Features in People With Patellofemoral Pain: An International Consensus Process With Health Care Professionals. J Orthop Sports Phys Ther 2022; 52:29-39. [PMID: 34972490 DOI: 10.2519/jospt.2022.10647] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To decide clinical and research priorities on pain features and psychological factors in persons with patellofemoral pain. DESIGN Consensus development process. METHODS We undertook a 3-stage process consisting of (1) updating 2 systematic reviews on quantitative sensory testing of pain features and psychological factors in patellofemoral pain, (2) an online survey of health care professionals and persons with patellofemoral pain, and (3) a consensus meeting with expert health care professionals. Participants responded that they agreed, disagreed, or were unsure that a pain feature or psychological factor was important in clinical practice or as a research priority. Greater than 70% participant agreement was required for an item to be considered important in clinical practice or a research priority. RESULTS Thirty-five health care professionals completed the survey, 20 of whom attended the consensus meeting. Thirty persons with patellofemoral pain also completed the survey. The review identified 5 pain features and 9 psychological factors-none reached 70% agreement in the patient survey, so all were considered at the meeting. After the meeting, pain catastrophizing, fear-avoidance beliefs, and pain self-efficacy were the only factors considered clinically important. All but the thermal pain tests and 3 psychological factors were considered research priorities. CONCLUSION Pain catastrophizing, pain self-efficacy, and fear-avoidance beliefs were factors considered important in treatment planning, clinical examination, and prognostication. Quantitative sensory tests for pain were not regarded as clinically important but were deemed to be research priorities, as were most psychological factors. J Orthop Sports Phys Ther 2022;52(1):29-39. doi:10.2519/jospt.2022.10647.
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Feasibility of a short multidisciplinary education and exercise therapy program for patients with non-specific low back pain: A 3-month retrospective open pilot study. Ann Phys Rehabil Med 2019; 62:382-385. [DOI: 10.1016/j.rehab.2019.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/05/2019] [Accepted: 05/07/2019] [Indexed: 11/23/2022]
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Dupeyron A, Lanhers C, Bastide S, Alonso S, Toulotte M, Jourdan C, Coudeyre E. The Back Belief Questionnaire is efficient to assess false beliefs and related fear in low back pain populations: A transcultural adaptation and validation study. PLoS One 2017; 12:e0186753. [PMID: 29211745 PMCID: PMC5718465 DOI: 10.1371/journal.pone.0186753] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 10/06/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND According to the fear avoidance model, beliefs and thoughts can modify the outcome of patient with low back pain. The Back Belief Questionnaire (BBQ)-a 14 items scale-assesses these consequences of low back pain. OBJECTIVE To test the psychometric properties of the French version of the BBQ. METHODS The BBQ was translated using the forward-backward translation process. Throughout three repeated evaluation time points (D1, D7 and D30), various aspects of validity were analysed: acceptability, quality of items, unidimentionality, internal consistency, temporal stability (between D1 and D7), responsiveness (between D7 and D30), and construct validity comparing it to other validated scales. RESULTS One hundred and thirty-one patients were enrolled and 128 were analyzed. The acceptability and the quality of the items were excellent. The scale was unidimensional and reliable (internal consistency: Cronbach's α = 0.8). The responsiveness was moderate but in line with other scores. The BBQ was, as expected, convergent with day-to-day activities and fear avoidance (FABQ and Tampa), disability (Quebec and Dallas scores), or anxiety and depression (HAD); and not correlated with pain. Best correlations were found with Tampa and FABQ. The temporal stability (test-retest reliability) was poor. However, similar changes were observed in near conceptual score (FABQ), which confirmed that clinical status may have not been stable and suggesting sensitivity to early changes for BBQ. CONCLUSIONS The BBQ showed good psychometric properties to assess false beliefs and related fear in French or English LBP populations and can be used either for evaluation in international trials or as a part of self-care training.
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Affiliation(s)
- Arnaud Dupeyron
- Service de Médecine Physique et de Réadaptation, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
- EuroMov, Université de Montpellier, Montpellier, France
- * E-mail:
| | - Charlotte Lanhers
- Département de Médecine Physique et de Réadaptation, Centre Hospitalier Universitaire, Clermont-Ferrand, France
| | - Sophie Bastide
- Département de Biostatistique, Epidémiologie, Santé Publique et Informatique Médicale (BESPIM), Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Sandrine Alonso
- Département de Biostatistique, Epidémiologie, Santé Publique et Informatique Médicale (BESPIM), Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Matthias Toulotte
- Service de Médecine Physique et de Réadaptation, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Claire Jourdan
- Département de Médecine Physique et de Réadaptation, Centre Hospitalier Universitaire Lapeyronie, Montpellier, France
| | - Emmanuel Coudeyre
- Département de Médecine Physique et de Réadaptation, Centre Hospitalier Universitaire, Clermont-Ferrand, France
- INRA, Unité de Nutrition Humaine (UMR 1019), CRNH Auvergne, Clermont-Ferrand, France
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Yilmaz Yelvar GD, Çırak Y, Dalkılınç M, Parlak Demir Y, Guner Z, Boydak A. Is physiotherapy integrated virtual walking effective on pain, function, and kinesiophobia in patients with non-specific low-back pain? Randomised controlled trial. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 26:538-545. [DOI: 10.1007/s00586-016-4892-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 07/15/2016] [Accepted: 11/17/2016] [Indexed: 11/30/2022]
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Neblett R, Mayer TG, Hartzell MM, Williams MJ, Gatchel RJ. The Fear-avoidance Components Scale (FACS): Development and Psychometric Evaluation of a New Measure of Pain-related Fear Avoidance. Pain Pract 2015; 16:435-50. [PMID: 26228238 DOI: 10.1111/papr.12333] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/25/2015] [Indexed: 11/30/2022]
Abstract
Pain-related fear avoidance (FA), a common problem for patients with painful medical conditions, involves pain-related catastrophizing cognitions, hypervigilance, and avoidance behaviors, which can ultimately lead to decreased functioning, depression, and disability. Several patient-reported instruments have been developed to measure FA, but they have been criticized for limited construct validity, inadequate item specificity, lack of cutoff scores, and missing important FA components. The Fear-Avoidance Components Scale (FACS) is a new patient-reported measure designed to comprehensively evaluate FA in patients with painful medical conditions. It combines important components of FA found in prior FA scales, while trying to correct some of their deficiencies, within a framework of the most current FA model. Psychometric evaluation of the FACS found high internal consistency (α = 0.92) and high test/retest reliability (r = 0.90-0.94, P < 0.01). FACS scores differentiated between 2 separate chronic pain patient samples and a nonpatient comparison group. When clinically relevant severity levels were created, FACS severity scores were highly associated with FA-related patient-reported psychosocial and objective lifting performance variables. These results suggest that the FACS is a psychometrically strong and reliable measure that can help healthcare providers assess FA-related barriers to function and recovery.
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Affiliation(s)
| | - Tom G Mayer
- Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A
| | | | | | - Robert J Gatchel
- Department of Psychology, College of Science, The University of Texas at Arlington, Arlington, Texas, U.S.A
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Demoulin C, Bruyère O, Somville PR, Vanderthommen M. Low back pain-related meta-analysis: Caution is needed when interpreting published research results. World J Meta-Anal 2015; 3:93-96. [DOI: 10.13105/wjma.v3.i2.93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 02/21/2015] [Accepted: 04/07/2015] [Indexed: 02/05/2023] Open
Abstract
The systematic reviews (SRs) including a meta-analysis are considered as the top level of evidence. Although the existence of more than a hundred of low back pain (LBP)-related SRs seems very appealing and might therefore suggest significant evidence on the topic, a deep analysis indicates that several of these SRs included only very few studies. Other SRs raise concerns because they included some randomized controlled trials which had a low methodological quality, or some studies which differed significantly regarding the studied populations and/or the experimental procedure. The sometimes controversial results of different SRs conducted on the same topic also highlight the significant influence of the inclusion/exclusion criteria used in the SRs to select the articles. To conclude, although meta-analysis is at the top of the evidence pyramid and have several strengths, the conclusions drawn from SRs should always be interpreted with caution because they can also have weaknesses. This is true, whether it be for LBP-related SRs including a meta-analysis, or any other. Therefore a critical analysis of any SR is always needed before integrating the results of the SR in its own clinical practice. Furthermore, clinical reasoning remains crucial, especially to consider the potential differences between one’s patient and the patients included in the meta-analysis.
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